Faculty mentor/PI email address
Yschneid@virtua.org
Is your research Teaching and Learning based?
1
Keywords
Obesity, Cholecystectomy, Surgery, BMI
Date of Presentation
5-6-2026 12:00 AM
Poster Abstract
Background: Obesity is traditionally associated with higher perioperative risk, yet observational data suggest an "obesity paradox" in which obese patients experience comparable or better outcomes than non-obese peers. We evaluated the impact of obesity (BMI ≥30 kg/m²) and obesity class on post-cholecystectomy outcomes.
Methods: A retrospective cohort study was conducted using the TriNetX global federated network. Adults undergoing cholecystectomy with BMI < 30 kg/m² were propensity score–matched 1:1 to those with BMI ≥30 kg/m², yielding 81,048 patients per group. Primary outcomes included choledocholithiasis, procedural complications, need for ERCP, and ED/inpatient utilization; secondary outcomes included mortality, respiratory and cardiovascular complications, and upgrade of care. Outcomes were assessed at 6 months and 1 year. A prespecified subgroup analysis compared BMI 30–39 versus BMI ≥40 kg/m² (40,238 per cohort).
Results: Obese patients consistently demonstrated lower rates of major outcomes at both timepoints. At 1 year, BMI < 30 had higher risks of choledocholithiasis (9.1% vs. 8.0%; RR 1.13), procedural complications (3.8% vs. 3.1%; RR 1.22), ERCP (5.4% vs. 4.6%; RR 1.19), and ED/inpatient visits (30.3% vs. 28.8%; RR 1.05; all p< 0.001). Mortality was also higher in non-obese patients at 1 year (1.4% vs. 1.2%; RR 1.20). Within the obese subgroup, BMI 30–39 and BMI ≥40 had broadly similar complication and utilization rates, though 1-year mortality was lowest in class I–II obesity (0.8% vs. 1.0%; RR 0.85).
Conclusions: Obesity was associated with better post-cholecystectomy outcomes compared with BMI < 30 kg/m², supporting an obesity paradox in biliary surgery. BMI alone should not deter cholecystectomy, and perioperative risk stratification should incorporate factors beyond weight class.
Disciplines
Digestive System Diseases | Medicine and Health Sciences | Nutritional and Metabolic Diseases
Obesity paradox in post-cholecystectomy outcomes: a BMI class–based TriNetX analysis at 6 months and 1 year
Background: Obesity is traditionally associated with higher perioperative risk, yet observational data suggest an "obesity paradox" in which obese patients experience comparable or better outcomes than non-obese peers. We evaluated the impact of obesity (BMI ≥30 kg/m²) and obesity class on post-cholecystectomy outcomes.
Methods: A retrospective cohort study was conducted using the TriNetX global federated network. Adults undergoing cholecystectomy with BMI < 30 kg/m² were propensity score–matched 1:1 to those with BMI ≥30 kg/m², yielding 81,048 patients per group. Primary outcomes included choledocholithiasis, procedural complications, need for ERCP, and ED/inpatient utilization; secondary outcomes included mortality, respiratory and cardiovascular complications, and upgrade of care. Outcomes were assessed at 6 months and 1 year. A prespecified subgroup analysis compared BMI 30–39 versus BMI ≥40 kg/m² (40,238 per cohort).
Results: Obese patients consistently demonstrated lower rates of major outcomes at both timepoints. At 1 year, BMI < 30 had higher risks of choledocholithiasis (9.1% vs. 8.0%; RR 1.13), procedural complications (3.8% vs. 3.1%; RR 1.22), ERCP (5.4% vs. 4.6%; RR 1.19), and ED/inpatient visits (30.3% vs. 28.8%; RR 1.05; all p< 0.001). Mortality was also higher in non-obese patients at 1 year (1.4% vs. 1.2%; RR 1.20). Within the obese subgroup, BMI 30–39 and BMI ≥40 had broadly similar complication and utilization rates, though 1-year mortality was lowest in class I–II obesity (0.8% vs. 1.0%; RR 0.85).
Conclusions: Obesity was associated with better post-cholecystectomy outcomes compared with BMI < 30 kg/m², supporting an obesity paradox in biliary surgery. BMI alone should not deter cholecystectomy, and perioperative risk stratification should incorporate factors beyond weight class.